Dietary assessment in minority ethnic groups: a systematic review of instruments for portion-size estimation in the United Kingdom

Context: Dietary assessment in minority ethnic groups is critical for surveillance programs and for implementing effective interventions. A major challenge is the accurate estimation of portion sizes for traditional foods and dishes. Objective: The aim of this systematic review was to assess records published up to 2014 describing a portion-size estimation element (PSEE) applicable to the dietary assessment of UK-residing ethnic minorities. Data sources, selection, and extraction: Electronic databases, internet sites, and theses repositories were searched, generating 5683 titles, from which 57 eligible full-text records were reviewed. Data analysis: Forty-two publications about minority ethnic groups (n = 20) or autochthonous populations (n = 22) were included. The most common PSEEs (47%) were combination tools (eg, food models and portion-size lists), followed by portion-size lists in questionnaires/guides (19%) and image-based and volumetric tools (17% each). Only 17% of PSEEs had been validated against weighed data. Conclusions: When developing ethnic-specific dietary assessment tools, it is important to consider customary portion sizes by sex and age, traditional household utensil usage, and population literacy levels. Combining multiple PSEEs may increase accuracy, but such methods require validation.